Change-sensitive Measurement of Emotion Dysregulation in ASD

ASD 情绪失调的变化敏感测量

• 批准号: 9276754
• 负责人: Carla A Mazefsky
• 金额: $ 44.95万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-10 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9276754
• 关键词: Achievement; Address; Admission activity; Affect; Aggressive behavior; Anxiety; Area; Attention; Autistic Disorder; Award; Behavior; Calibration; Caregiver Burden; Caregivers; Child; Clinical; Clinical Trials; Cognitive; Communities; Comorbidity; Data Collection; Data Set; Depressed mood; Development; Dimensions; Emotional; Emotions; Equipment and supply inventories; Evaluation; Evidence based treatment; FDA approved; Factor Analysis; Genetic; Gold; Guidelines; Heterogeneity; Hospitalization; Hyperactive behavior; Impairment; Individual; Information Systems; Inpatients; Interview; Lead; Life; Measurement; Measures; Mental Depression; Mental disorders; Modeling; Online Systems; Outcome Measure; Outcome Study; Outpatients; Output; Parents; Participant; Patient Outcomes Assessments; Persons; Pharmaceutical Preparations; Phenotype; Population; Population Study; Problem behavior; Process; Property; Provider; Psychiatric Diagnosis; Psychiatric therapeutic procedure; Psychometrics; Psychopathology; Recording of previous events; Regulation; Research; Sampling; Severities; Source; Structure; Symptoms; Testing; Time; autism spectrum disorder; base; behavior observation; emotion dysregulation; emotion regulation; emotional distress; externalizing behavior; innovation; instrument; literacy; neuroimaging; primary outcome; psychiatric symptom; public health relevance; response; stereotypy; theories; treatment effect; treatment planning; user-friendly; young adult

DESCRIPTION (provided by applicant): Individuals with autism spectrum disorder (ASD) are often in need of psychiatric care due to poor emotion regulation and emotional distress. Only two psychotropic medications have been approved for use in ASD, both to treat irritability expressed as tantrums, outbursts, and aggression. However, the underlying deficits in emotion regulation that lead to these problem behaviors are poorly understood and rarely measured or targeted in treatment. Evidence-based treatment approaches for the full range of emotion dysregulation (e.g. depression, outbursts, meltdowns, etc.) present in ASD do not exist. A major barrier to progress in this area is a lack of validated, treatment sensitive measures of emotional distress for individuals with ASD. This project proposes to refine and validate a new measure of emotional distress and emotion regulation for ASD, called the Emotion Dysregulation Inventory (EDI). Guidelines from the Patient-Reported Outcome Measurement Information System (PROMIS) Project and gold-standard statistical approaches will be utilized to complete calibration and psychometric analysis of the EDI. The primary sample will include caregivers of 1000 children and young adults with ASD from community, outpatient, and psychiatric inpatient settings. Data collection will occur through an online system. Analyses will focus on establishing the EDI's factor structure/dimensionality, developing a less than 10-item short form, establishing convergent and divergent validity, comparing EDI scores among groups whose scores would be expected to differ (e.g. inpatients versus community sample; ASD versus healthy controls), and comparing EDI scores to observational counts of emotion dysregulation episodes displayed by children who are inpatients on two specialized psychiatric units. A subset of the sample will complete the EDI twice to establish test-retest reliability. The EDI's ability to detect treatment change will be determined by comparing both caregiver- and provider-rated EDI scores at admission and discharge across two psychiatric inpatient units that specialize in ASD and 4-week change scores in a stable community sample. The primary outcome of this study will be a user-friendly (e.g. available online, brief), validated, treatment sensitive outcome measure for clinical trials in ASD that is independent of verbal ability. In addition, this study will produce he largest existing dataset on emotion dysregulation in ASD, which will be used to identify emotional profiles and treatment needs in this population. Additional time-course questions in the EDI that tap the individual's history of emotion dysregulation will be useful for clinical conceptualization and helping to understand the boundaries between emotion dysregulation that is inherent in ASD and comorbid psychiatric disorders. Finally, having a sensitive measure of emotion dysregulation in ASD will aid in understanding heterogeneity in genetic and neuroimaging research and will enable cross-population studies

描述（由申请人提供）：自闭症谱系障碍（ASD）患者往往由于情绪调节能力差和情绪困扰而需要精神科护理。只有两种精神药物被批准用于ASD，都是用于治疗表现为发脾气、爆发和攻击的易怒。然而，导致这些问题行为的情绪调节的潜在缺陷很少被理解，很少被测量或有针对性的治疗。针对ASD中出现的全方位情绪失调（如抑郁、爆发、崩溃等）的循证治疗方法并不存在。在这一领域取得进展的一个主要障碍是缺乏针对ASD患者的有效的、治疗敏感的情绪困扰措施。本项目提出完善和验证一种新的ASD情绪困扰和情绪调节的测量方法，称为情绪失调量表（EDI）。患者报告结果测量信息系统（PROMIS）项目的指南和金标准统计方法将用于完成EDI的校准和心理测量分析。主要样本将包括来自社区、门诊和精神科住院环境的1000名自闭症儿童和青少年的护理人员。数据收集将通过在线系统进行。分析将侧重于建立EDI的因素结构/维度，开发少于10项的简短形式，建立收敛效度和分歧效度，比较EDI得分在预期得分不同的群体之间（例如，住院患者与社区样本；ASD与健康对照），并将EDI得分与两个专业精神科住院儿童表现出的情绪失调发作的观察性计数进行比较。样本的子集将完成EDI两次，以建立测试-重测试的可靠性。EDI检测治疗变化的能力将通过比较两个专门治疗ASD的精神科住院病房入院和出院时护理人员和提供者评定的EDI分数以及稳定社区样本的4周变化分数来确定。这项研究的主要结果将是一个用户友好的（例如，在线提供，简短），有效的，治疗敏感的结果测量，用于ASD临床试验，独立于语言能力。此外，这项研究将产生最大的关于ASD情绪失调的现有数据集，这将用于确定该人群的情绪概况和治疗需求。EDI中附加的时间过程问题挖掘了个体情绪失调的历史，这将有助于临床概念化，并有助于理解ASD和共病精神疾病固有的情绪失调之间的界限。最后，对ASD的情绪失调有一个敏感的测量将有助于理解遗传和神经影像学研究的异质性，并将使跨人群研究成为可能